Lichen sclerosus (LS) is a long-term inflammatory skin condition that mainly affects the genital and anal area. It makes the skin thin, fragile, and itchy. It’s not contagious. With proper treatment, symptoms can be controlled and complications reduced.
Who gets it
- Most common in women after menopause, but can affect any age and males too.
- In men, it often affects the foreskin and tip of the penis (also called balanitis xerotica obliterans).
- May relate to autoimmunity; it can run in families.
Symptoms
- Intense itching, burning, or soreness.
- White, smooth, thin patches that can tear and bleed easily.
- Pain with sex, peeing (if fissures), or bowel movements (if perianal).
- In men: tight foreskin, painful erections, urinary spraying.
Why it matters
- Repeated scratching/tearing can scar and narrow genital openings.
- Small increased risk of skin cancer (squamous cell carcinoma) in the affected area over many years if untreated. Regular care reduces this risk.
Diagnosis
- Usually by exam. A small skin biopsy is sometimes done if the diagnosis is unclear, not responding to treatment, or to check a suspicious area.
Treatment
- Strong prescription steroid ointment (e.g., clobetasol) is first-line:
- Typically used daily for several weeks, then slowly reduced to a maintenance schedule (for example, 1–2 times weekly).
- This is safe and protective when used as directed; it strengthens the skin by controlling inflammation.
- Gentle care: fragrance-free cleanser, bland ointments (petrolatum) as barrier; avoid tight clothes and irritants.
- Sex comfort: lubricants; address pain early to avoid fear and pelvic floor tension.
- In men with tight foreskin not responding to treatment, circumcision can help.
- If steroids are not tolerated/insufficient, your clinician may try calcineurin inhibitor ointments (tacrolimus/pimecrolimus).
Follow-up
- Regular checkups (for example every 6–12 months once controlled).
- Seek care promptly for new persistent sores, thickened areas, color changes, or bleeding.
Everyday tips
- Moisturize daily with a bland ointment.
- Urinate after sex, use gentle hygiene, and pat dry—don’t rub.
- Consider a soft toilet paper or a peri bottle to reduce friction.